Rasmussen College NUR 2063 Pathophysiology Final Exam.

What is Gastritis/Acute Gastritis? - THE CORRECT ANSWER IS Inflammation of the stomach lining. Causes include ingestion of alcohol, aspirin, NSAIDs; can also be caused by a virus, bacteria, an autoimmune disorder Trea ...

What is Gastritis/Acute Gastritis? - THE CORRECT ANSWER IS Inflammation of the stomach lining. Causes include ingestion of alcohol, aspirin, NSAIDs; can also be caused by a virus, bacteria, an autoimmune disorder Treatment: Remove the offending agent! Chronic Gastritis - THE CORRECT ANSWER IS *H.Pylori is almost always a factor Causes: Person-to-Person, Fecal/Oral, Reservoir in water sources Complications: PUD, Atrophic Gastritis, Gastric Adenocarcinoma, Mucosal Lymphoma, Decreased Acid, and Intrinsic Factor PUD - Peptic Ulcer Disease - THE CORRECT ANSWER IS Disorders of the upper GI Tract caused by the action of Acid and Pepsin. Injury to the mucosa of the esophagus, stomach, and duodenum. Causes: *H.Pylori (HIGHLY CONTAGIOUS), NSAIDs, Stress, Smoking, and Genetics Clinical Manifestations: Epigastric burning pain (relieved by food intake or antacids) Complications: GI Bleeding and Perforation Tx: Sulcralfate, PPIs, Avoid caffeine and alcohol PUD - Ulcer Types: MOST COMMON - THE CORRECT ANSWER IS Gastric Ulcer: Pain occurs on an empty stomach; may present soon after a meal Duodenal Ulcer: Pain 2-3 hours after meal; relieved by food intake Ulcerative Colitis (IBD - Inflammatory Bowel Disease) - THE CORRECT ANSWER IS Chronic inflammation of the mucosa - rectal and colon - leading to large ulcers Complications: *Bloody Diarrhea, Lower abdominal pain; *Exacerbations and Remissions Treatment: Corticosteroids, Broad Spectrum Antibiotics Chron's Disease - THE CORRECT ANSWER IS An immune-mediated disease that can affect any part of the digestive tract. There is NO CURE. Complications: Granulomas, Fistulas, Ulcerations, Strictures, and Fibrosis Bowel Obstruction Manifestations - Types - THE CORRECT ANSWER IS Mechanical: Increased bowel sounds, abdominal pain, and N/V Functional: Absent bowel sounds Upper Jejunal: Vomiting, dehydration, and electrolyte depletion Distal Small Bowel/Ilium: Constipation What percentage of the pancreas is Endocrine function? - THE CORRECT ANSWER IS 5% - Pancreas secretes hormones into the blood *Exocrine function: Pancreas secretes digestive juice into the duodenum Pancreatic Cancer - THE CORRECT ANSWER IS About 2% of all CA; Ranks 4th among malignant deaths. Risks: Smoking, Obesity Manifestations: Jaundice, Malabsorption, weight loss, abdominal pain, nausea Tx: Surgery, Chemo Gastroesophageal Varices Management - THE CORRECT ANSWER IS Varicies are a result of Portal Hypertension d/t Cirrhosis of the liver; Alcoholism and Viral Hepatitis Dx: Endoscopy, Abdominal CT Scan, Upper GI Barrium Tx: Fluids (NaCl), Administer Blood Products, Vasopressin IV, H2 Blockers, PPIs; Surgical Banding and Balloon Therapy Diverticulosis - THE CORRECT ANSWER IS Syndrome of "Outpouchings"/Herniations through the muscular layer of the colon. *HIGH FIBER DIET Diverticulitis - THE CORRECT ANSWER IS Inflammation of the "Outpouchings" *LOW FIBER DIET Assessment of Kidney Disease - THE CORRECT ANSWER IS Palpation of the CVA for pain/tenderness *CVA = Costalvertebral Angle Kidney Cancer S/S - THE CORRECT ANSWER IS Is typically asymptomatic until advanced. Most common is CVA tenderness, hematuria, palpable abdominal mass, dyspnea, cough, bone pain secondary to metastasis Dialysis Benefits and Risks - THE CORRECT ANSWER IS Used for pts with ATN/CKD in stage 5 in order to remove metabolic waste and correct fluid and electrolyte imbalances. Pts are at risk for Hypotension after treatment because they Hypertensive prior to treatment. TYPES of Acute Kidney Injury (AKI) - THE CORRECT ANSWER IS PRERENAL: Conditions that diminish perfusion of the kidney - Hypovolemia, Hypotension, Heart Failure, Renal Artery Obstruction, Fever, Burns, Edema, Ascites, ACE Inhibitors, NSAIDs POSTRENAL: Obstruction of the normal outflow of urine from kidneys - Renal Pelvis, Ureters, Bladder Outlet, Urethra Causes: BPH, Kinked Catheter, Intra-abdominal Tumors, Strictures, Calculi INTRINSIC/INTRARENAL: Primary dysfunction of the nephrons and the kidney itself! The most common problem within the renal tubules results in *ATN(Acute Tubular Necrosis). Causes of ATN: Nephrotoxic insults: Contrast Media, Sepsis, Vancomycin, Chemo; Lack of O2, Alcohol, Drugs PHASES of Acute Kidney Injury (AKI) - THE CORRECT ANSWER IS PRODROMAL: *Insult to the kidney has already occurred. Serum BUN and Creatinine is ELEVATED. OLIGURIC: Normal urine output of 50-400mL daily. Oliguria, Uremia, decreased GFR, Hypervolemia. S/S: Fluid excess, Hyperkalemia, Uremic Syndrome, Metabolic Acidosis POSTOLIGURIC: Termination of the Oliguric phase represents recovery. Urine volume increases, tubular function improves fluid volume deficit until kidneys recover. Cystitis - THE CORRECT ANSWER IS Acute onset of frequency, Urgency and Dysuria, Suprapubic Pain, Hematuria, Cloudy Urine. LOC in elderly could present as Dementia, as well as new-onset incontinence. Toxic Causes of Intrarenal Kidney Injury - THE CORRECT ANSWER IS Prolonged postrenal failure, blood transfusion reaction, antibiotics/antifungal, antiviral, *CONTRAST MEDIA, chemo drugs, recreational drugs, snake venom, environmental factors Renin Angiotensin-Aldosterone System (RAAS) and the relationship between the autoregulation and the kidneys - THE CORRECT ANSWER IS Kidneys attempt to: Regulate Perfusion and Maintain GFR Glomerulus - THE CORRECT ANSWER IS Is located in the Nephron inside the kidney. It is also the site of fluid filtration Gomerulonephritis - THE CORRECT ANSWER IS Inflammation of the glomeruli within the kidney. Immune-mediated conditions that produce IgA Nephropathy, Berger's Disease: These are the most commonly diagnosed What will be spilling into the urine? PROTEIN! Characterized by abrupt onset of hematuria, proteinuria, oliguria, edema, and hypertension Staph infection associated with glomerulonephritis Type I Diabetes - THE CORRECT ANSWER IS *Makes NO insulin. It is characterized by the destruction of B cells of the pancreas. It affects children and adolescents. HYPERGLYCEMIA Type II Diabetes - THE CORRECT ANSWER IS *Insulin Resistant and is the most common type of diabetes. What is resistant to the insulin? CELLS and PERIPHERAL TISSUE. Risks include: Obesity, Aging, Sedentary Lifestyle Polys of Diabetes - THE CORRECT ANSWER IS *Hyperglycemia: Polydipsia, Polyphasia, Polyuria Cushing's Syndrome - THE CORRECT ANSWER IS *Hypercortisolism: Characterized by mood swings, insomnia, Moon Face, Fine hair, Hirsutism, Truncal Obesity, Thin skin Traumatic Brain Injury (TBI) - THE CORRECT ANSWER IS A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes. *Leading cause of death and disability in the U.S. TBI - Primary Injury - THE CORRECT ANSWER IS Result of the initial trauma or injury on brain cells. Focal:Localized Injury Polar: Caused by acceleration/deceleration movement of brain within the the skull: Double injury Diffuse: Caused by movement of brain within the skull: Axonal injury TBI - Secondary Injury - THE CORRECT ANSWER IS Increases ICP and pt usually dies Reperfusion Injury - THE CORRECT ANSWER IS Secondary injury that occurs after reestablishing blood flow. Tx/Therapy: Medication, Surgery to restore blood flow to blocked arteries Increased Cranial Pressure (ICP) - THE CORRECT ANSWER IS The pressure exerted by the contents of the cranium. 0-15 mm Hg The volume of the cranium consists of CSF, Blood and Brain Tissue The patient might be sedated. May need to raise the HOB and ensure there is no stimulation in the environment What is the most sensitive indicator of altered brain function? - THE CORRECT ANSWER IS Change in the patient's LOC! Cerebrovascular Disease (CVA): Types of Stroke - THE CORRECT ANSWER IS ISCHEMIC: Sudden occlusion of a cerebral artery secondary to thrombus formation or embolization. Insufficient blood flow to the brain tissue results in oxygen deprivation and rapid cerebral deterioration. Thrombotic is r/t atherosclerosis and hypercoaguability Embolic is r/t cardiac source HEMORRHAGIC: Intracerebral brain bleed Diagnosed by CT Scan! Meningitis - THE CORRECT ANSWER IS Inflammation of the meninges of the brain and spinal cord. Microbial invasion of the CNS. Streptococcus Pneumoniae is the most common bacterium. Bacteria reaches the CNS via the bloodstream, para-nasal sinuses or ears Encephalitis - THE CORRECT ANSWER IS Inflammation of the brain usually caused by a virus. Herpes Virus is the most common viral cause. Glascow Coma Scale (GCS) - THE CORRECT ANSWER IS A neurological scaled used to determine the level of consciousness of a patient. Mild 13-15 Moderate 9-12 Severe 8 or below Seizure Disorders: Classifications - THE CORRECT ANSWER IS Generalized: Whole-brain surface is affected Absence (Petit-Mal): Kids, Staring spells Atypical Absence: Myoclonic Jerks Myoclonic: Single to Several Jerks Atonic: DROP attack/Fall down Tonic-Clonic (Grand-Mal): Jerking/Many Muscles Status Epilepticus - THE CORRECT ANSWER IS Back-to-Back Seizures with no recovery in between episodes Dementia - THE CORRECT ANSWER IS A slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes What is NOT a clinical manifestation of HYPONATREMIA? - THE CORRECT ANSWER IS THIRST T or F: Thirst is a clinical manifestation of HYPERnatremia - THE CORRECT ANSWER IS True What electrolytes are affected by the kidney's inability to regulate? - THE CORRECT ANSWER IS Potassium, Phosphorous, Magnesium Hypoventilation is a build up of what? - THE CORRECT ANSWER IS PaCO2 What is the goal for a pt with ARDS (Acute Respiratory Distress Syndrome) - THE CORRECT ANSWER IS Keep the pts PaO2 value >60! What is the tx for Tension Pneumothorax? - THE CORRECT ANSWER IS Emergent needle aspiration/decompression *Chest tube placement with H2O seal Pneumonia - THE CORRECT ANSWER IS Inflammatory reaction in the alveoli and interstitium of the lung. *Can result from 3 sources: 1. Aspiration of Oropharyngeal secretions composed of normal bacterial flora and/or gastric contents 2. Inhalation of contaminants (virus-Mycoplasma) 3. Contamination from the systemic circulation Classifications: Community or Hospital-Acquired, bacterial, atypical, and viral. Risks: Elderly, pts with a diminished gag reflex, critically ill, pts hospitalized, hypoxic pts, immunocompromised pts C.Manifestations: Chills, cough, fever, headache, malaise Dx: Chest x-ray, Sputum C&S, WBC>15,000 Tx: Antibiotic Therapy How is TB transmitted? - THE CORRECT ANSWER IS Airborne, Droplet; Spreads via Cough, Sneeze, Shouting, Singing Sources of Electrolyte Stores - THE CORRECT ANSWER IS BONES serve as a reservoir of calcium, magnesium, phosphate ions. CELLS serve as a reservoir of potassium, magnesium, phosphate and calcium ions **Also known as ELECTROLYTE POOLS!! Anemia - THE CORRECT ANSWER IS Lack of RBCs to carry O2 to tissues. S/S: Tired, Weak, Fatigue What is the hormone that kidneys secrete? - THE CORRECT ANSWER IS *ERYTHROPOIETIN: Stimulates production of RBCs Polycythemia - THE CORRECT ANSWER IS RBCs are present in excess, increasing blood viscocity and causing hypertension. Thrombocytopenia - THE CORRECT ANSWER IS A common cause of Generalized bleeding. Regardless of the cause, fewer platelets are available, and inadequate hemostasis is the potential result! Causes: Radiation, Chemo, Anemia, Bone cancer, viral and bacterial infections, DIC, Splenomegaly, Hypothermia, Massive blood transfusions C.Manifestations: Spontaneous mucosal, deep tissue, and intracranial bleeding Dx: Low platelet count Tx: dc suspected drug, avoid aspirin *Administer corticosteroids, immunosuppressants, IV immunoglobulin, rituximab *Splenectomy may be helpful: removes a major site of platelet destruction DIC (Disseminated Intravascular Coagulation) - THE CORRECT ANSWER IS Acquired hemorrhagic syndrome in which both clotting and bleeding occur simultaneously. Widespread clotting in small vessels leads to the consumption of the clotting factors and platelets causing bleeding. Tx: Removal or correction of the underlying cause and support of major organ systems. Replacement of depleting clotting factors with fresh frozen plasma, packed RBCs, platelets, or cryoprecipitate may be needed. Chronic Myelogenous Leukemia (CML) - *Diagnosis is by identifying which chromosome abnormality? - THE CORRECT ANSWER IS Ph+ (Philadelphia Chromosome) S/S: High granulocyte count on CBC and splenomegaly. Fatigue, Weight Loss, Diaphoresis, Bleeding, Abdominal pain d/t enlarged spleen *Prognosis is POOR GERD (Gastroesophageal Reflux Disease) - THE CORRECT ANSWER IS Backflow of gastric contents into the esophagus through the LES. C.Manifestations: Heartburn, regurgitation, chest pain, dysphagia Complications: Esophageal strictures; Barret Esophagus, Pulmonary symptoms r/t esophagitis: cough, asthma, and laryngitis Tx: PPIs are the mainstays fo treatment for chronic GERD. However, long-term use can lead to malabsorption of vitamin B12, iron, magnesium, and calcium. Increasing LES pressure, enhancing esophageal clearance, improving gastric emptying and suppressing gastric acidity. Avoid smoking and aggravating food/drink, OTC antacids and histamine blockers. Initial symptoms of Malignancies - THE CORRECT ANSWER IS Weight loss, decreased appetite, cough, lumps, change in bowel or bladder habits, bleeding, discharge, fever What would a nurse expect to find in a pt with ARF (Acute Respiratory Failure)? - THE CORRECT ANSWER IS Respiratory Acidosis A toddler ingested morphine, a medication that causes respiratory depression. What condition(s) would you monitor this pt for? - THE CORRECT ANSWER IS Hypoxemia and Hypercapnia Severe hypoxemia is a common finding in a serious condition known as: - THE CORRECT ANSWER IS ARDS (Acute Respiratory Distress Syndrome) Patients with COPD experience air trapped in the alveoli. This leads to the appearance of: - THE CORRECT ANSWER IS Barrel chest Hypoventilation has symptoms r/t: - THE CORRECT ANSWER IS Decreased CO2 in the alveoli What equipment would you need in the emergency treatment for a pt with a Tension Pneumothorax? - THE CORRECT ANSWER IS Chest tube with H2O seal What is the essential complication of Anemeia? What is the goal of the treatment for Anemia? - THE CORRECT ANSWER IS Complication is tissue hypoxia, and the goal for treatment is to restore tissue oxygenation Which of the following are CM of Left Sided Heart Failure? Select all that apply. Jugular Venous Distension Cough with frothy sputum Crackles auscultated in lungs Dyspnea - THE CORRECT ANSWER IS Cough with frothy sputum, Crackles auscultated in lungs, and Dyspnea Which of the following would be normal ABG values? pH 7.40, PaCO2 40, PaO2 90, HCO3 24 pH 7.25, PaCO2 52, PaO2 75, HCO3 18 pH 7.50, PaCO2 30, PaO2 80, HCO3 28 pH 7.15, PaCO2 30, PaO2 50, HCO3 24 - THE CORRECT ANSWER IS pH 7.40, PaCO2 40, PaO2 90, HCO3 24 T or F: Malignancies of blood-forming tissues may present initially as Non-Specific or NO symptoms. - THE CORRECT ANSWER IS TRUE Myocardial Ischemia - THE CORRECT ANSWER IS Deficiency of blood supply to the myocardium. Caused by blockage of the coronary artery d/t buildup of plaque Hodgkin's disease - THE CORRECT ANSWER IS *Characterized by Reed-Sternberg cells! Type of malignant cancer that affects the lymph tissue found in lymph nodes and the spleen. 5-year survival rate is 85% Tx: Radiation and/or chemo What is the difference between Hodgkin's and NON-Hodgkin's disease? - THE CORRECT ANSWER IS NON-Hodgkin's may arise in lymph nodes anywhere in the body. Hodgkin's lymphoma typically begins in the upper body, such as the neck, chest or armpits. It is often diagnosed at an early stage and is therefore considered one of the most treatable cancers. Hypertension - Modifiable Risk Factors - THE CORRECT ANSWER IS These are things pts can DO SOMETHING ABOUT! Obesity, Sedentary Lifestyle, Diet, Tobacco use Treatment: *Lifestyle Changes and Drug Therapy! Weight loss, exercise, diet, decrease sodium intake, alcohol moderation, Anti-hypertensive drugs Hypertension - Non modifiable Risk Factors - THE CORRECT ANSWER IS Age, Family History, Genetics Hypertension Treatment - THE CORRECT ANSWER IS Lifestyle changes are the first and most important. Weight loss, Exercise, Diet, Decrease Sodium, Alcohol Moderation, Drug Therapy What organs are affected with Hypertension? - THE CORRECT ANSWER IS Heart and Arteries, Kidneys, Brain: Increased ICP, Eyes: Diabetes can cause an increase in IOP, Glaucoma, Orthostatic Hypotension - THE CORRECT ANSWER IS Decrease in blood pressure related to positional or postural changes from lying to sitting or standing positions Decrease in Systolic BP>20mm Hg within 3 min of moving to an upright position Decrease in Diastolic BP>10mm Hg within 10 min of moving to upright position Atherosclerotic plaque - THE CORRECT ANSWER IS The cholesterol-rich material that is deposited in the arteries of individuals with atherosclerosis. It consists of cholesterol, smooth muscle cells, fibrous tissue, and eventually calcium. CAD (Coronary Artery Disease) - THE CORRECT ANSWER IS Characterized by insufficient delivery of oxygenated blood to the myocardium (ischemia) d/t atherosclerotic coronary arteries. Non-modifiable risk factors: Age, Gender, Family Hx Modifiable risk factors: Smoking, Diet, Exercise Acute Coronary Syndrome - 2 Types of MI (Myocardial Infarction) - THE CORRECT ANSWER IS STEMI: Complete Occlusion; ECG shows Elevated ST; Labs show +Triponin NON-STEMI: NO Elevated ST Dx: 12 Lead ECG: ST segment elevation, large Q waves, and inverted T waves, severe crushing, excruciating chest pain that radiates to the arm, jaw, or back, N/V, diaphoresis, SOB What is the difference between Stable and Unstable Angina? - THE CORRECT ANSWER IS Chest pain is NOT relieved by periods of rest Unstable Angina Pectoris - THE CORRECT ANSWER IS Prolonged, worsening chest pain occurs without exertion, not relieved by rest or nitroglycerin. Left sided heart failure symptoms - THE CORRECT ANSWER IS 1. Pnea, SOB 2. Crackles 3. Oliguria 4. Frothy Sputum 5. Displaced Apical Pulse (Hypertrophy) Right sided heart failure symptoms - THE CORRECT ANSWER IS 1. Jungular Vein Distention 2. Ascending Dependent Edema 3. Weight Gain 4. Hepatomegaly (Liver Enlargement) Causes swelling in extremeties Medication management for Systolic Heart Failure - THE CORRECT ANSWER IS ACE Inhibitors, Beta Blockers, Diuretics Effects of Right Sided Heart Failure - THE CORRECT ANSWER IS *Fluid in the body backs up in the right side of the heart Systemic Edema*legs, ankles, abdominal ascites, Hepatosplenomegaly Systemic venous congestion results in impaired function of the liver, portal system, spleen, kidneys, peripheral subcutaneous tissues, and brain MI signs and symptoms - THE CORRECT ANSWER IS Severe crushing, excruciating chest pain May radiate to arm, shoulder, jaw, or back Lasts more than 15 minutes Not relieved by NTG or rest Nausea/vomiting Diaphoresis SOB Pallor Impending doom Ischemia - THE CORRECT ANSWER IS O2 supply is unable to meet Metabolic Demands; inadequate blood supply to an organ or part of the body, especially the heart muscles. Coronary Heart Disease Risk Factors - THE CORRECT ANSWER IS Family history, smoking, high blood pressure, high cholesterol, obesity, diabetes, high stress, physical inactivity Atherosclerosis, Microcirculation HDL: Good cholesterol LDL: Bad cholesterol What is the goal of treating Sepsis? - THE CORRECT ANSWER IS Treat the underlying cause What is the pathogenesis of shock? - THE CORRECT ANSWER IS Shock is characterized by an imbalance between oxygen supply and oxygen requirements at the cellular level. Without O2 and Nutrients, cells cannot meet metabolic demands. This leads to cellular hypoxia and may progress to irreversible organ damage and death. All types of SHOCK have a Decrease in O2. Impaired O2 to the tissues results in tissue ischemia, which leads to cellular dysfunction. What are the 4 Types of Circulatory Shock? - THE CORRECT ANSWER IS 1. Cardiogenic: MI, Cardiomyopathy, Congenital Defects *Pump failure with severe ventricular dysfunction 2. Obstructive: d/t Pulmonary Embolism, Tension Pneumothorax, Aortic Aneurysm 3. Hypovolemic: Acute Hemorrhage, Dehydration d/t vomiting/diarrhea, Diuretics, Burns *Loss of fluid, Insufficient volume *1, 2, and 3 are Circulatory Shock! 4. Distributive Shock: Anaphylaxis: Bronchoconstriction, Peripheral Dilation, Increased Capillary Permeability d/t immune Response Neurotrauma, Spinal Cord Trauma, Sepsis Septic Shock - THE CORRECT ANSWER IS Most commonly associated with GRAM NEGATIVE BACTERIA Shock Signs and Symptoms - THE CORRECT ANSWER IS Initially, pt will be tachycardic for a short time. *Decreased O2, Decreased HR, Poor perfusion, oliguria, altered mental status, variable pulse pressure, fast/deep respirations, cyanotic, cool-clammy skin, dilated pupils How do cancer cells metastasize? - THE CORRECT ANSWER IS Cancer cells can escape the tissue of origin and create new colonies. They have the ability to invade adjacent tissues. Cells spread via the bloodstream and lymphatic systems. Cancer cells escape the basement membrane of the tissue of origin, move through the extracellular space, and penetrate the basement membrane of the vessel. This process repeats itself to access the blood or lymphatic system. Metastasis has gone into the Bony Tissue. What does this tell us? - THE CORRECT ANSWER IS Cancer has migrated to somewhere else in the body CVA (Cerebrovascular Accident/Stroke) - THE CORRECT ANSWER IS Characterized by numbness or weakness of the face, arm, or leg - especially only effecting one side of the body; confusion, trouble speaking, visual disturbances, dizziness, loss of balance, difficulty walking, headache Osteoporosis - THE CORRECT ANSWER IS A condition in which the body's bones become weak and break easily. *Most common metabolic bone disease that affects 10 million people in the U.S. over the age of 50. *Bone resorption is greater than bone formation Immunoglobulin allergic hypersensitivity reactions - THE CORRECT ANSWER IS IgE is responsible for initiating inflammatory and allergic reactions. It functions as a signaling molecule and causes mast cell degranulation when an antigen is detected. IgE binds to WBCs, resulting in the release of histamine: most important mediator to hypersensitivity! Passive Immunity - THE CORRECT ANSWER IS Immunity conferred by transferring antibodies from an individual who is immune to a pathogen to another individual. Examples: IgG antibodies can cross the placental barrier; IgA antibodies reach newborns through breast milk Clinical indicator of Acute Blood Loss - Orthostatic Hypotension - THE CORRECT ANSWER IS Volume depletion as occurs in hemorrhage, burns, or severe diarrhea may reach a point where normal compensatory responses to position changes are inadequate Asthma - THE CORRECT ANSWER IS Characterized by: Airway obstruction that is reversible, Airway Inflammation, and Increased Airway reactivity to stimuli. S/S: Wheezing, Dyspnea, Cough Airway inflammation leads to epithelial denudation, increased secretions, and smooth muscle contraction *Most common chronic disease of children IgE receptors activate the release of histamine! What are the most important inflammatory mediators in Allergic Asthma? - THE CORRECT ANSWER IS Cytokines: Particularly those associated with TH2 helper T-cell activation! Exercised Induced Asthma - THE CORRECT ANSWER IS Common in children and adolescents. Bronchospasm occurs within 3 minutes after the end of exercise and usually resolves in 60 minutes. Running, jogging, and playing tennis are the most common instigators What causes Hepatic Encephalopathy? - THE CORRECT ANSWER IS The liver gets damaged from disease: Cirrhosis, Hepatitis Toxins get into the bloodstream and travel to the brain Emphysema - THE CORRECT ANSWER IS Type A COPD Destructive changes in the ALVEOLAR WALLS, and abnormal enlargement of the DISTAL AIR SACS d/t AIR ENTRAPMENT "Pink Puffer" Type B COPD "Blue Bloater" ARDS - THE CORRECT ANSWER IS Hallmark is Hypoxemia refractory to increased levels of supplemental O2. Damage to the alveolar capillary membrane You are having a stroke. Upon arrival to the hospital, what is the 1st diagnostic test to be performed? - THE CORRECT ANSWER IS CT Scan What has happened in the LATE STAGES OF SHOCK with the cells? - THE CORRECT ANSWER IS Cellular Necrosis 6 P's of Arterial Occlusion - THE CORRECT ANSWER IS Pallor, Paresthesia, Paralysis, Pain, Polar, Pulseless BPH (Benign Prostatic Hyperplasia) - THE CORRECT ANSWER IS Most common symptoms: Inability to start/continue urinary stream; dribble Where are the most frequent Peptic Ulcers found? - THE CORRECT ANSWER IS Duodenum and Stomach What is Sickle Cell Anemia? - THE CORRECT ANSWER IS A severe hereditary disorder where hemoglobin distorts the red blood cells into a crescent shape. Cells die early, leaving a shortage of healthy RBCs and can block blood flow and cause pain. Sickle cells cause vascular occlusion, severe Anemia, RBCs of different shapes and sizes, recurrent painful episodes. Tx: Stem cell transplant pH (Hydrogen Ions) - THE CORRECT ANSWER IS Acid 7.35-7.45 Alkaline This value measures how many hydrogen ions are in the blood sample. Tells you whether blood is acidic or alkaline. PaCO2 (Carbon Dioxide) - THE CORRECT ANSWER IS Alkaline 35-45 Acid This value tells you if the problem is respiratory in origin, as CO2 is regulated by the Lungs. HCO3 (Bicarbonate) - THE CORRECT ANSWER IS 22-26 mEq/L This value will tell you whether the problem is related to metabolic changes in the pt, and refers to the Renal system. Kidneys Hypoventilation - THE CORRECT ANSWER IS Air delivered to alveoli is insufficient to provide O2 and remove CO2. Increased PaCO2 causes Hypoxemia Hyperventilation - THE CORRECT ANSWER IS Increase of air entering the alveoli Decreased PaCO2 causes Hypocapnia Hypoxia - THE CORRECT ANSWER IS Decrease in tissue oxygenation Hypoxemia - THE CORRECT ANSWER IS Deficient blood oxygen as measured by LOW arterial O2 and LOW hemoglobin saturation MS (Multiple Sclerosis) - THE CORRECT ANSWER IS Chronic Demyelinating disease of the CNS Inflammation and scarring of myelin sheaths Exacerbations and remissions d/t heat, infection, trauma, stress Guillain Barre Syndrome - THE CORRECT ANSWER IS Inflammatory Demyelinating disease of the PNS Progressive ascending weakness or paralysis; may affect respiratory muscles Major mechanisms of Spinal Cord Injuries - THE CORRECT ANSWER IS Hyperflexion, Hyperextension, Compression Treatment for Spinal Cord Injuries - THE CORRECT ANSWER IS Surgery: Internal and/or External Fixation Virchow's Triad of PE - THE CORRECT ANSWER IS Factors causing thromboemboli formation : Hypercoagulability, Damage to venous wall/'intimal injury', and Venous Stasis/sluggish blood flow Aplastic Anemia - THE CORRECT ANSWER IS Stem cell disorder characterized by LOW RBC, WBC, Platelets Causes: Toxic, radiant, or immunologic injury to the bone marrow stem cells Diagnosis: Bone marrow biopsy Late S/S: Weakness, fatigue, lethargy, pallor, dyspnea, palpitations, transient murmurs and tachycardia r/t low RBCs